To tell or not to tell? That is the question facing many people who have a chronic illness such as multiple sclerosis (MS), inflammatory bowel disease (IBD), arthritis, epilepsy or dozens of other debilitating conditions.

Unlike disability, chronic illness is not always visible and for a long time a sufferer may be perfectly well. At other times they may have to take weeks off which can have implications for their careers and their employers. There is also a spectrum with many of these illnesses from mild to severe and sometimes employers do not make that distinction.

This provides an unenviable dilemma at a time in the job market where there is such competition for every post. In an ideal world applicants would only ever be judged on their ability to do the job and their job record, but in reality an employer might decide to give the job to somebody less qualified but who does not have health issues.

Unemployment rate
The issue is a serious one. Rates of unemployment among people with chronic illnesses are invariably higher than those who do not have such illnesses.

Though epilepsy is a very manageable condition, a recent survey carried out by Epilepsy Ireland, found that nearly 20 per cent of Irish people would not employ somebody with the illness.

A study carried out at St Vincent’s hospital among sufferers of the two IBDs – Crohn’s and ulcerative colitis – showed rates of unemployment of 36 per cent and 26 per cent respectively, much higher than the general population.

Rachel Ashe said she had told people she had epilepsy and still got employed as a digital marketing executive with Hayes recruitment. She set up a Facebook page for people with epilepsy. It now has 823 members and employment is an issue that arises quite a lot.

“Personally, I’d be hesitant to make a big deal of it. If you are going into an interview and talking about it in a negative way, that is not the best way to go forward and that negative connotation is then put on to the employer,” she said.

Others have better experiences. “We had one member who was out of work for six months and he feared the company would let him go.

“Instead, they reacted fantastically to it. He felt accepted. Employers are changing their point of view. We are hearing more positive stories than negative stories. My own employers have been beyond good to me.”

Susan Mitchell, who also has epilepsy, said she now works for a company that is very supportive. "That's not always the case. I was effectively constructively dismissed because of the diagnosis when I was first diagnosed five years ago. I had no choice but to leave.

“I was being asked if I could work with the public, use the computer and all that sort of stuff. That was completely off the wall.My advice is to disclose because it takes the fear out of it for you and for your employer. If an employer takes you on with epilepsy, they will be more flexible with you.”

'A real struggle'
Emma Rogan, who was diagnosed with MS in 2007, has won a Vodafone Foundation World of Difference award for her work in ensuring that fellow sufferers get the best from life. She said having a chronic illness was a "real struggle. Employers are quite ruthless in who they employ. We have equality legislation, but that does not necessarily mean they will look beyond the condition."

She said people with MS often struggle from the perception that it is some kind of a terminal illness when so many of those with it can live normal lives.

Many people with MS are diagnosed in the prime of their lives in their 20s and 40s when they should be close to their earning peaks. She advises that people with MS should not apply for jobs that they could not do and should find a flexible employer “where diversity matters and is respected as a welcome addition to the business”.

“Every individual is different,” she said. “Determining whether someone with a condition should ‘disclose’ isn’t the relevant question. If you can do the job, apply for the role. None of us can predict the future so don’t get in your way by predicting changes in your condition.”

The good news for those with chronic illness is that they do not need to declare it unless it is a threat to their health and safety and to that of their colleagues.

Deirdre Lynch, a partner with the Matheson law firm specialising in employment law, said the non-disclosure of illness was "irrelevant to the course of action open to an employer in this situation and would not change the protection available to the employee against discriminatory dismissal". She said an employer could terminate employment on the grounds of incapacity but they must demonstrate what accommodations they have made with their employee.

Kanchi, a charity working with employers on disability issues, takes a different approach. It is engaged from an employer’s point of view in making them aware that people with disabilities and chronic illnesses can contribute to the workplace in a positive fashion. “Legally employers are not allowed to discriminate against people who have a disability or a chronic illness. In the real world, there is still discrimination in some cases,” said Terry Fahy, learning, development and disability consultant. “When we are working with businesses, we really encourage them to work around inclusiveness. They need to say it to people and there needs to be a culture of inclusion and people are much more likely to disclose that they have a disability if they feel confident that they will not be discriminated against,” said Fahy.

Mary Connaughton of Irish Business and Employers Confederation (Ibec) said people with chronic illnesses may find employers to be much more accommodating than they would believe.

“Employers recruit on skills. Can this person do a particular job? For epilepsy it might cross them off doing one job, but not another, for instance,” she said.

She said employers should not make judgments as to whether a potential employee would have high levels of absenteeism as a result of their illness, but should leave that to professional medical assessors.